Analyst, Audit Support – CGSO

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Provide support to Medicare, Commercial, and Medicaid clients that assign Prior Authorizations, Organization Determinations, Coverage Determinations, and Appeals to CVS Caremark.

• Guarantee impeccable audit performance.

• Ensure that health plan clients receive accurate, consistent, and timely documentation/files for audit-related tasks.

• Comprehend and implement CMS guidance and business requirements.

• Complete tasks with urgency and adhere to established timelines.

• Maintain professional communication internally with the Client Audit Team, Account Management Team, Reporting Teams, and other departments.

• Demonstrate attention to detail, excellent verbal and written communication skills, and critical thinking.

⛳️ Requirements

• Over 3 years of prior experience in PBM - Commercial and Medicare.

• Proficient in Excel, Word, and Adobe Acrobat Pro or CutePDF Pro preferred.

• Strong knowledge of MedHOK and CAS systems preferred.

• Motivation, presentation skills, and adaptability are essential.

• Ability to meet tight deadlines.

• Proven ability to collaborate with individuals at all levels within an organization.

• Exceptional communication skills, both oral and written.

• Familiarity with Medicare Coverage Determination and Appeals activities or Commercial activities preferred.

• Ability to work across departments to achieve objectives.

• Self-motivated with a proven ability to manage and prioritize multiple projects simultaneously while meeting deadlines.

• Energetic and highly driven to provide outstanding client support and service.

• High School diploma or equivalent GED.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.